103D CONGRESS

2D SESSION S. 2433

AN ACT

To amend title VIII of the Public Health Service

purposes.cation programs under such title, and for otherAct to consolidate and reauthorize nursing edu-
103D CONGRESS

2D SESSION S. 2433

AN ACT

To amend title VIII of the Public Health Service Act to

consolidate and reauthorize nursing education programs

under such title, and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Nursing Education

5 Consolidation and Reauthorization Act of 1994’’.
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1 SEC. 2. PURPOSE.

2 It is the purpose of this Act to restructure the nurse

3 education authorities of title VIII of the Public Health

4 Service Act to permit a comprehensive, flexible, and effec5 tive approach to Federal support for nursing workforce

6 development.

7 SEC. 3. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

8 Title VIII of the Public Health Service Act (42

9 U.S.C. 296k et seq.) is amended—

10 (1) by striking the title heading and all that fol11 lows except for subparts II and III of part B and

12 section 855; and inserting the following:

13 ‘‘TITLE VIII—NURSING

14 WORKFORCE DEVELOPMENT’’;

15 (2) in subpart II of part B, by striking the sub16 part heading and inserting the following:

17 ‘‘PART E—STUDENT LOANS

18 ‘‘Subpart I—General Program’’;

19 (3) by redesignating subpart III as subpart II;

20 (4) by striking section 837;

21 (5) in section 846, by striking subsection (d)

22 and inserting the following new subsection:

23 ‘‘(d) BREACH OF AGREEMENTS FOR OBLIGATED

24 SERVICE.—

25 ‘‘(1) IN GENERAL.—In the case of any program

26 under this section under which an individual makes
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1 an agreement to provide health services for a period

2 of time in accordance with such program in consid3 eration of receiving an award of Federal funds re4 garding education as a nurse (including an award

5 for the repayment of loans), the following applies if

6 the agreement provides that this subsection is appli7 cable:

8 ‘‘(A) In the case of a program under this

9 section that makes an award of Federal funds

10 for attending an accredited program of nursing

11 (in this subsection referred to as a ‘nursing pro12 gram’), the individual is liable to the Federal

13 Government for the amount of such award (in14 cluding amounts provided for expenses related

15 to such attendance), and for interest on such

16 amount at the maximum legal prevailing rate,

17 if the individual—

18 ‘‘(i) fails to maintain an acceptable

19 level of academic standing in the nursing

20 program (as indicated by the program in

21 accordance with requirements established

22 by the Secretary);

23 ‘‘(ii) is dismissed from the nursing

24 program for disciplinary reasons; or
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1 ‘‘(iii) voluntarily terminates the nurs2 ing program.

3 ‘‘(B) The individual is liable to the Federal

4 Government for the amount of such award (in5 cluding amounts provided for expenses related

6 to such attendance), and for interest on such

7 amount at the maximum legal prevailing rate,

8 if the individual fails to provide health services

9 in accordance with the program under this sec10 tion for the period of time applicable under the

11 program.

12 ‘‘(2) WAIVER OR SUSPENSION OF LIABILITY.—

13 In the case of an individual or health facility making

14 an agreement for purposes of paragraph (1), the

15 Secretary shall provide for the waiver or suspension

16 of liability under such paragraph if compliance by

17 the individual or the health facility, as the case may

18 be, with the agreements involved is impossible, or

19 would involve extreme hardship to the individual or

20 facility, and if enforcement of the agreements with

21 respect to the individual or facility would be uncon22 scionable.

23 ‘‘(3) DATE CERTAIN FOR RECOVERY.—Subject

24 to paragraph (2), any amount that the Federal Gov25 ernment is entitled to recover under paragraph (1)
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1 shall be paid to the United States not later than the

2 expiration of the 3-year period beginning on the date

3 the United States becomes so entitled.

4 ‘‘(4) AVAILABILITY.—Amounts recovered under

5 paragraph (1) with respect to a program under this

6 section shall be available for the purposes of such

7 program, and shall remain available for such pur8 poses until expended.’’;

9 (6) by inserting after the title heading the fol10 lowing new parts:

11 ‘‘PART A—GENERAL PROVISIONS

12 ‘‘SEC. 801. DEFINITIONS.

13 ‘‘As used in this title:

14 ‘‘(1) ELIGIBLE ENTITIES.—The term ‘eligible

15 entities’ means schools of nursing, nursing centers,

16 State or local governments, and other public or non17 profit private entities determined appropriate by the

18 Secretary that submit to the Secretary an applica19 tion in accordance with section 802.

20 ‘‘(2) SCHOOL OF NURSING.—The term ‘school

21 of nursing’ means a collegiate, associate degree, or

22 diploma school of nursing in a State.

23 ‘‘(3) COLLEGIATE SCHOOL OF NURSING.—The

24 term ‘collegiate school of nursing’ means a depart25 ment, division, or other administrative unit in a col-
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1 lege or university which provides primarily or exclu2 sively a program of education in professional nursing

3 and related subjects leading to the degree of bach4 elor of arts, bachelor of science, bachelor of nursing,

5 or to an equivalent degree, or to a graduate degree

6 in nursing, and including advanced training related

7 to such program of education provided by such

8 school, but only if such program, or such unit, col9 lege or university is accredited.

10 ‘‘(4) ASSOCIATE DEGREE SCHOOL OF NURS11 ING.—The term ‘associate degree school of nursing’

12 means a department, division, or other administra13 tive unit in a junior college, community college, col14 lege, or university which provides primarily or exclu15 sively a two-year program of education in profes16 sional nursing and allied subjects leading to an asso17 ciate degree in nursing or to an equivalent degree,

18 but only if such program, or such unit, college, or

19 university is accredited.

20 ‘‘(5) DIPLOMA SCHOOL OF NURSING.—The

21 term ‘diploma school of nursing’ means a school af22 filiated with a hospital or university, or an independ23 ent school, which provides primarily or exclusively a

24 program of education in professional nursing and al25 lied subjects leading to a diploma or to equivalent
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1 indicia that such program has been satisfactorily

2 completed, but only if such program, or such affili3 ated school or such hospital or university or such

4 independent school is accredited.

5 ‘‘(6) ACCREDITED.—

6 ‘‘(A) IN GENERAL.—Except as provided in

7 subparagraph (B), the term ‘accredited’ when

8 applied to any program of nurse education

9 means a program accredited by a recognized

10 body or bodies, or by a State agency, approved

11 for such purpose by the Secretary of Education

12 and when applied to a hospital, school, college,

13 or university (or a unit thereof) means a hos14 pital, school, college, or university (or a unit

15 thereof) which is accredited by a recognized

16 body or bodies, or by a State agency, approved

17 for such purpose by the Secretary of Education.

18 For the purpose of this paragraph, the Sec19 retary of Education shall publish a list of recog20 nized accrediting bodies, and of State agencies,

21 which the Secretary of Education determines to

22 be reliable authority as to the quality of edu23 cation offered.

24 ‘‘(B) NEW PROGRAMS.—A new school of

25 nursing that, by reason of an insufficient period
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1 of operation, is not, at the time of the submis2 sion of an application for a grant or contract

3 under this title, eligible for accreditation by

4 such a recognized body or bodies or State agen5 cy, shall be deemed accredited for purposes of

6 this title if the Secretary of Education finds,

7 after consultation with the appropriate accredi8 tation body or bodies, that there is reasonable

9 assurance that the school will meet the accredi10 tation standards of such body or bodies prior to

11 the beginning of the academic year following

12 the normal graduation date of students of the

13 first entering class in such school.

14 ‘‘(7) NONPROFIT.—The term ‘nonprofit’ as ap15 plied to any school, agency, organization, or institu16 tion means one which is a corporation or association,

17 or is owned and operated by one or more corpora18 tions or associations, no part of the net earnings of

19 which inures, or may lawfully inure, to the benefit

20 of any private shareholder or individual.

21 ‘‘(8) STATE.—The term ‘State’ means a State,

22 the Commonwealth of Puerto Rico, the District of

23 Columbia, the Commonwealth of the Northern Mari24 ana Islands, Guam, American Samoa, the Virgin Is25 lands, or the Trust Territory of the Pacific Islands.
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1 ‘‘SEC. 802. APPLICATION.

2 ‘‘(a) IN GENERAL.—To be eligible to receive a grant

3 or contract under this title, an eligible entity shall prepare

4 and submit to the Secretary an application that meets the

5 requirements of this section, at such time, in such manner,

6 and containing such information as the Secretary may re7 quire.

8 ‘‘(b) PLAN.—An application submitted under this

9 section shall contain the plan of the applicant for carrying

10 out a project with amounts received under this title. Such

11 plan shall be consistent with relevant Federal, State, or

12 regional program plans.

13 ‘‘(c) PERFORMANCE OUTCOME STANDARDS.—An ap14 plication submitted under this section shall contain a spec15 ification by the applicant entity of performance outcome

16 standards that the project to be funded under the grant

17 or contract will be measured against. Such standards shall

18 address relevant national nursing needs that the project

19 will meet. The recipient of a grant or contract under this

20 section shall meet the standards set forth in the grant or

21 contract application.

22 ‘‘(d) LINKAGES.—An application submitted under

23 this section shall contain a description of the linkages with

24 relevant educational and health care entities, including

25 training programs for other health professionals as appro-
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1 priate, that the project to be funded under the grant or

2 contract will establish.

3 ‘‘SEC. 803. USE OF FUNDS.

4 ‘‘(a) IN GENERAL.—Amounts provided under a grant

5 or contract awarded under this title may be used for train6 ing program development and support, faculty develop7 ment, model demonstrations, trainee support including

8 tuition, books, program fees and reasonable living ex9 penses during the period of training, technical assistance,

10 workforce analysis, and dissemination of information, as

11 appropriate to meet recognized nursing objectives, in ac12 cordance with this title.

13 ‘‘(b) MAINTENANCE OF EFFORT.—With respect to

14 activities for which a grant awarded under this title is to

15 be expended, the entity shall agree to maintain expendi16 tures of non-Federal amounts for such activities at a level

17 that is not less than the level of such expenditures main18 tained by the entity for the fiscal year preceding the fiscal

19 year for which the entity receives such a grant.

20 ‘‘SEC. 804. MATCHING REQUIREMENT.

21 ‘‘The Secretary may require that an entity that ap22 plies for a grant or contract under this title provide non23 Federal matching funds, as appropriate, to ensure the in24 stitutional commitment of the entity to the projects funded

25 under the grant. Such non-Federal matching funds may
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1 be provided directly or through donations from public or

2 private entities and may be in cash or in-kind, fairly evalu3 ated, including plant, equipment, or services.

4 ‘‘SEC. 805. PREFERENCE.

5 ‘‘In awarding grants or contracts under this title, the

6 Secretary shall give preference to applicants with projects

7 that will substantially benefit rural or underserved popu8 lations.

9 ‘‘SEC. 806. GENERALLY APPLICABLE PROVISIONS.

10 ‘‘(a) AWARDING OF GRANTS AND CONTRACTS.—The

11 Secretary shall ensure that grants and contracts under

12 this title are awarded on a competitive basis to carry out

13 innovative demonstration projects or provide for strategic

14 workforce supplementation activities as needed to meet

15 national nursing service goals and in accordance with this

16 title.

17 ‘‘(b) INFORMATION REQUIREMENTS.—Recipients of

18 grants and contracts under this title shall meet informa19 tion requirements as specified by the Secretary.

20 ‘‘(c) TRAINING PROGRAMS.—Training programs con21 ducted with amounts received under this title shall meet

22 applicable accreditation and quality standards.

23 ‘‘(d) DURATION OF ASSISTANCE.—

24 ‘‘(1) IN GENERAL.—Subject to paragraph (2),

25 in the case of an award to an entity of a grant, co-
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1 operative agreement, or contract under this title, the

2 period during which payments are made to the en3 tity under the award may not exceed 5 years. The

4 provision of payments under the award shall be sub5 ject to annual approval by the Secretary of the pay6 ments and subject to the availability of appropria7 tions for the fiscal year involved to make the pay8 ments. This paragraph may not be construed as lim9 iting the number of awards under the program in10 volved that may be made to the entity.

11 ‘‘(2) LIMITATION.—In the case of an award to

12 an entity of a grant, cooperative agreement, or con13 tract under this title, paragraph (1) shall apply only

14 to the extent not inconsistent with any other provi15 sion of this title that relates to the period during

16 which payments may be made under the award.

17 ‘‘(e) PEER REVIEW REGARDING CERTAIN PRO18 GRAMS.—Each application for a grant under this title, ex19 cept advanced nurse traineeship grants under section

20 811(a)(2), shall be submitted to a peer review group for

21 an evaluation of the merits of the proposals made in the

22 application. The Secretary may not approve such an appli23 cation unless a peer review group has recommended the

24 application for approval. Each peer review group under

25 this subsection shall be composed principally of individuals
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1 who are not officers or employees of the Federal Govern2 ment. This subsection shall be carried out by the Secretary

3 acting through the Administrator of the Health Resources

4 and Services Administration.

5 ‘‘SEC. 807. NATIONAL ADVISORY COUNCIL ON NURSE EDU6 CATION AND PRACTICE.

7 ‘‘(a) ESTABLISHMENT.—There is hereby established

8 a National Advisory Council on Nurse Education and

9 Practice (in this section referred to as the ‘Council’), con10 sisting of the Secretary or the delegate of the Secretary

11 (who shall be an ex officio member and shall serve as the

12 Chairperson), and 15 members appointed by the Secretary

13 without regard to the Federal civil service laws, of which—

14 ‘‘(1) 2 shall be selected from full-time students

15 enrolled in schools of nursing;

16 ‘‘(2) 3 shall be selected from the general public;

17 ‘‘(3) 2 shall be selected from practicing profes18 sional nurses; and

19 ‘‘(4) 8 shall be selected from among the leading

20 authorities in the various fields of nursing, higher,

21 and secondary education, and from representatives

22 of hospitals and other institutions and organizations

23 which provide nursing services.

24 A majority of the members shall be nurses. The student25 members of the Council shall be appointed for terms of
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1 one year and shall be eligible for reappointment to the

2 Council.

3 ‘‘(b) DUTIES.—The Council shall advise the Sec4 retary in the preparation of general regulations and with

5 respect to policy matters arising in the administration of

6 this title, including the range of issues relating to nurse

7 supply, education and practice improvement.

8 ‘‘(c) FUNDING.—Amounts appropriated under this

9 title may be utilized by the Secretary to support the nurse

10 education and practice activities of the Council.

11 ‘‘SEC. 808. TECHNICAL ASSISTANCE.

12 ‘‘Funds appropriated under this title may be used by

13 the Secretary to provide technical assistance in relation

14 to any of the authorities under this title.

15 ‘‘SEC. 809. RECOVERY FOR CONSTRUCTION ASSISTANCE.

16 ‘‘(a) IN GENERAL.—If at any time within 20 years

17 (or within such shorter period as the Secretary may pre18 scribe by regulation for an interim facility) after the com19 pletion of construction of a facility with respect to which

20 funds have been paid under subpart I of part A (as such

21 subpart was in effect on September 30, 1985)—

22 ‘‘(1) the owner of the facility ceases to be a

23 public or nonprofit school,

24 ‘‘(2) the facility ceases to be used for the train25 ing purposes for which it was constructed, or
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1 ‘‘(3) the facility is used for sectarian instruction

2 or as a place for religious worship,

3 the United States shall be entitled to recover from the

4 owner of the facility the base amount prescribed by sub5 section (c)(1) plus the interest (if any) prescribed by sub6 section (c)(2).

7 ‘‘(b) NOTICE OF CHANGE IN STATUS.—The owner of

8 a facility which ceases to be a public or nonprofit school

9 as described in paragraph (1) of subsection (a), or the

10 owner of a facility the use of which changes as described

11 in paragraph (2) or (3) of such subsection shall provide

12 the Secretary written notice of such cessation or change

13 of use within 10 days after the date on which such ces14 sation or change of use occurs or within 30 days after

15 the date of enactment of the Health Professions Training

16 Assistance Act of 1985, whichever is later.

17 ‘‘(c) AMOUNT OF RECOVERY.—

18 ‘‘(1) BASE AMOUNT.—The base amount that

19 the United States is entitled to recover under sub20 section (a) is the amount bearing the same ratio to

21 the then value (as determined by the agreement of

22 the parties or in an action brought in the district

23 court of the United States for the district in which

24 the facility is situated) of the facility as the amount
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1 of the Federal participation bore to the cost of the

2 construction.

3 ‘‘(2) INTEREST.—

4 ‘‘(A) IN GENERAL.—The interest that the

5 United States is entitled to recover under sub6 section (a) is the interest for the period (if any)

7 described in subparagraph (B) at a rate (deter8 mined by the Secretary) based on the average

9 of the bond equivalent rates of 91-day Treasury

10 bills auctioned during such period.

11 ‘‘(B) TIME PERIOD.—The period referred

12 to in subparagraph (A) is the period begin13 ning—

14 ‘‘(i) if notice is provided as prescribed

15 by subsection (b), 191 days after the date

16 on which the owner of the facility ceases to

17 be a public or nonprofit school as described

18 in paragraph (1) of subsection (a), or 191

19 days after the date on which the use of the

20 facility changes as described in paragraph

21 (2) or (3) of such subsection, or

22 ‘‘(ii) if notice is not provided as pre23 scribed by subsection (b), 11 days after the

24 date on which such cessation or change of

25 use occurs,
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1 and ending on the date the amount the United

2 States is entitled to recover if collected.

3 ‘‘(d) WAIVER OF RIGHTS.—The Secretary may waive

4 the recovery rights of the United States under subsection

5 (a)(2) with respect to a facility (under such conditions as

6 the Secretary may establish by regulation) if the Secretary

7 determines that there is good cause for waiving such

8 rights.

9 ‘‘(e) LIMITATION ON LIENS.—The right of recovery

10 of the United States under subsection (a) shall not, prior

11 to judgment, constitute a lien on any facility.

12 ‘‘PART B—NURSE PRACTITIONERS, NURSE MID13 WIVES, AND OTHER ADVANCED PRACTICE

14 NURSES

15 ‘‘SEC. 811. ADVANCED PRACTICE NURSING GRANTS.

16 ‘‘(a) IN GENERAL.—The Secretary may award grants

17 to and enter into contracts with eligible entities to meet

18 the costs of—

19 ‘‘(1) projects that support the enhancement of

20 advanced practice nursing education and practice;

21 and

22 ‘‘(2) traineeships for individuals in advanced

23 practice nursing programs.

24 ‘‘(b) DEFINITION OF ADVANCED PRACTICE

25 NURSES.—For purposes of this section, the term ‘ad-
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1 vanced practice nurses’ means nurses trained in advanced

2 degree programs including individuals in combined R.N./

3 Master’s degree programs, post-nursing master’s certifi4 cate programs, or, in the case of nurse midwives or nurse

5 anesthetists, in certificate programs that received funding

6 under this title on the date that is one day prior to the

7 date of enactment of this section, to serve as nurse practi8 tioners, nurse midwives, nurse anesthetists, nurse edu9 cators, or public health nurses, or in other nurse special10 ties determined by the secretary to require advanced edu11 cation.

12 ‘‘(c) AUTHORIZED NURSE PRACTITIONER AND

13 NURSE-MIDWIFERY PROGRAMS.—

14 ‘‘(1) IN GENERAL.—Nurse practitioner and

15 nurse midwifery programs eligible for support under

16 this section are educational programs for registered

17 nurses (irrespective of the type of school of nursing

18 in which the nurses received their training) that—

19 ‘‘(A) meet guidelines prescribed by the

20 Secretary in accordance with paragraph (2);

21 and

22 ‘‘(B) have as their objective the education

23 of nurses who will upon completion of their

24 studies in such programs, be qualified to effec25 tively provide primary health care, including
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1 primary health care in homes and in ambula2 tory care facilities, long-term care facilities and

3 other health care institutions.

4 ‘‘(2) GUIDELINES.—After consultation with ap5 propriate educational organizations and professional

6 nursing and medical organizations, the Secretary

7 shall prescribe guidelines for programs described in

8 paragraph (1). Such guidelines shall, as a minimum,

9 require that such a program—

10 ‘‘(A) extend for at least one academic year

11 and consist of—

12 ‘‘(i) supervised clinical practice di13 rected toward preparing nurses to deliver

14 primary health care; and

15 ‘‘(ii) at least four months (in the ag16 gregate) of classroom instruction that is so

17 directed; and

18 ‘‘(B) have an enrollment of not less than

19 six full-time equivalent students.

20 ‘‘(d) OTHER AUTHORIZED EDUCATIONAL PRO21 GRAMS.—The Secretary shall prescribe guidelines as ap22 propriate for other advanced practice nurse education pro23 grams eligible for support under this section.

24 ‘‘(e) TRAINEESHIPS.—
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1 ‘‘(1) IN GENERAL.—The Secretary may not

2 award a grant to an applicant under subsection (a)

3 unless the applicant involved agrees that

4 traineeships provided with the grant will pay all or

5 part of the costs of—

6 ‘‘(A) the tuition, books, and fees of the

7 program of advanced nursing practice with re8 spect to which the traineeship is provided; and

9 ‘‘(B) the reasonable living expenses of the

10 individual during the period for which the

11 traineeship is provided.

12 ‘‘(2) DOCTORAL PROGRAMS.—The Secretary

13 may not obligate more than 10 percent of the

14 traineeships under subsection (a) for individuals in

15 doctorate degree programs.

16 ‘‘(3) SPECIAL CONSIDERATION.—In making

17 awards of grants and contracts under subsection

18 (a)(2), the Secretary shall give special consideration

19 to an eligible entity that agrees to expend the award

20 to train advanced practice nurses who will practice

21 in health professional shortage areas designated

22 under section 332.

23 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—

24 ‘‘(1) IN GENERAL.—There are authorized to be

25 appropriated to carry out this section, $50,000,000
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1 for fiscal year 1995, and such sums as may be nec2 essary for each of the fiscal years 1996 and 1997.

3 ‘‘(2) SET ASIDES.—Of the amount appropriated

4 under paragraph (1) for a fiscal year—

5 ‘‘(A) not less than 60 percent of such

6 amount shall be made available for projects to

7 enhance the training and practice of nurse

8 practitioners and nurse midwives; and

9 ‘‘(B) not less than 6 percent of such

10 amounts shall be made available for projects to

11 enhance the training and practice of nurse an12 esthetists.

13 ‘‘PART C—INCREASING NURSING WORKFORCE

14 DIVERSITY

15 ‘‘SEC. 821. WORKFORCE DIVERSITY GRANTS.

16 ‘‘(a) IN GENERAL.—The Secretary may award grants

17 to and enter into contracts with eligible entities to meet

18 the costs of special projects to increase nursing education

19 opportunities for individuals who are from disadvantaged

20 racial and ethnic backgrounds underrepresented among

21 registered nurses by providing student scholarships or sti22 pends, pre-entry preparation, and retention activities.

23 ‘‘(b) GUIDANCE.—In carrying out subsection (a), the

24 Secretary shall take into consideration the recommenda25 tions of the First and Second Invitational Congresses for
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1 Minority Nurse Leaders on ‘Caring for the Emerging Ma2 jority,’ in 1992 and 1993, and consult with nursing asso3 ciations including the American Nurses Association, the

4 National League for Nursing, the American Association

5 of Colleges of Nursing, the Black Nurses Association, the

6 Association of Hispanic Nurses, the Association of Asian

7 American and Pacific Islander Nurses, the National

8 Nurses Association, the Native American Indian and Alas9 kan Nurses Association.

10 ‘‘(c) REQUIRED INFORMATION AND CONDITIONS FOR

11 AWARD RECIPIENTS.—

12 ‘‘(1) IN GENERAL.—Recipients of awards under

13 this section may be required, where requested, to re14 port to the Secretary concerning the annual admis15 sion, retention, and graduation rates for ethnic and

16 racial minorities in the school or schools involved in

17 the projects.

18 ‘‘(2) FALLING RATES.—If any of the rates re19 ported under paragraph (1) fall below the average of

20 the two previous years, the grant or contract recipi21 ent shall provide the Secretary with plans for imme22 diately improving such rates.

23 ‘‘(3) INELIGIBILITY.—A recipient described in

24 paragraph (2) shall be ineligible for continued fund25 ing under this section if the plan of the recipient
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1 fails to improve the rates within the 1-year period

2 beginning on the date such plan is implemented.

3 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There

4 are authorized to be appropriated to carry out this section,

5 $5,000,000 for fiscal year 1995, and such sums as may

6 be necessary for each of the fiscal years 1996 and 1997.

7 ‘‘PART D—STRENGTHENING CAPACITY FOR

8 BASIC NURSE EDUCATION AND PRACTICE

9 ‘‘SEC. 831. BASIC NURSE EDUCATION AND PRACTICE

10 GRANTS.

11 ‘‘(a) IN GENERAL.—The Secretary may award grants

12 to and enter into contracts with eligible entities for

13 projects to strengthen capacity for basic nurse education

14 and practice.

15 ‘‘(b) PRIORITY AREAS.—In awarding grants or con16 tracts under this section the Secretary shall give priority

17 to entities that will use amounts provided under such a

18 grant or contract to enhance the education mix and utili19 zation of the basic nursing workforce by strengthening

20 programs that provide basic nurse education for purposes

21 of—

22 ‘‘(1) improving nursing services in schools and

23 other community settings;

24 ‘‘(2) providing care for underserved populations

25 and other high-risk groups such as the elderly, indi-
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1 viduals with HIV-AIDS, substance abusers, home2 less, and battered women;

3 ‘‘(3) providing case management, quality im4 provement, delegation and supervision, other skills

5 needed under new health care systems;

6 ‘‘(4) developing cultural competencies among

7 nurses;

8 ‘‘(5) providing emergency health services;

9 ‘‘(6) promoting career mobility for nursing per10 sonnel in a variety of training settings and cross

11 training or specialty training among diverse popu12 lation groups; or

13 ‘‘(7) other priority areas as determined by the

14 Secretary.

15 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There

16 are authorized to be appropriated to carry out this section,

17 $12,000,000 for fiscal year 1995, and such sums as may

18 be necessary for each of the fiscal years 1996 and 1997.’’;

19 and

20 (7) by redesignating section 855 as section 810,

21 and transferring such section so as to appear after

22 section 809 (as added by the amendment made by

23 paragraph (6)).
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1 SEC. 4. SAVINGS PROVISION AND TECHNICAL AMEND2 MENTS.

3 (a) SAVINGS PROVISION.—In the case of any author4 ity for making awards of grants or contracts that is termi5 nated by the amendment made by section 3, the Secretary

6 of Health and Human Services may, notwithstanding the

7 termination of the authority, continue in effect any grant

8 or contract made under the authority that is in effect on

9 the day before the date of the enactment of this Act, sub10 ject to the duration of any such grant or contract not ex11 ceeding the period determined by the Secretary in first

12 approving such financial assistance, or in approving the

13 most recent request made (before the date of such enact14 ment) for continuation of such assistance, as the case may

15 be.

16 (b) CLINICAL RESEARCHERS.—Paragraph (3) of sec17 tion 487E(a) of the Public Health Service Act (42 U.S.C.

18 288–5(a)(3)) is amended to read as follows:

19 ‘‘(3) APPLICABILITY OF CERTAIN PROVISIONS

20 REGARDING OBLIGATED SERVICE.—With respect to

21 the National Health Service Corps loan repayment

22 program established in subpart III of part D of title

23 III, the provisions of such subpart shall, except as

24 inconsistent with this section, apply to the program

25 established in subsection (a) in the same manner

26 and to the same extent as such provisions apply to
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1 the National Health Service Corps loan repayment

2 programs.’’.

3 (c) TECHNICAL AMENDMENTS.—Section 839 of such

4 Act (42 U.S.C. 297e) is amended—

5 (1) in subsection (a)—

6 (A) by striking the matter preceding para7 graph (1) and inserting the following:

8 ‘‘(a) If a school terminates a loan fund established

9 under an agreement pursuant to section 835(b), or if the

10 Secretary for good cause terminates the agreement with

11 the school, there shall be a capital distribution as fol12 lows:’’; and

13 (B) in paragraph (1), by striking ‘‘at the

14 close of September 30, 1999,’’ and inserting

15 ‘‘on the date of termination of the fund’’; and

16 (2) in subsection (b), to read as follows:

17 ‘‘(b) If a capital distribution is made under sub18 section (a), the school involved shall, after such capital dis19 tribution, pay to the Secretary, not less often than quar20 terly, the same proportionate share of amounts received

21 by the school in payment of principal or interest on loans

22 made from the loan fund established under section 835(b)

23 as determined by the Secretary under subsection (a).’’.
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1 SEC. 5. EFFECTIVE DATE.

2 This Act shall take effect on October 1, 1994, or the

3 date of enactment of this Act, whichever is later.

Passed the Senate October 6 (legislative day, September 12), 1994.

Attest:

Secretary.
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